Dementia panelists (l-r): Dr. Deborah Toiber, Ben Gurion University; Norma Kirby, Program Director for the Alzheimer's Society of Maniotba; Rose Popeski, daughter or parents with age-related dementia
By MYRON LOVEFor most people, if you live long enough, you are almost certain to develop some form of dementia. According to Ben-Gurion University of the Negev researcher Dr. Deborah Toiber, while the early signs of aged-related brain disease such as Alzheimer’s Disease may first appear in some people as young as 50, those symptoms most often appear after 70 and increase exponentially with age.

Ninety-five percent of those who live past 95 will have some form of age-related brain disease, Toiber told an audience of about 150 involved listeners on attendance at the St. Boniface Hospital’s Albrechtsen Research Centre on Wednesday, June 6.

As Sheldon Zamick, president of the Winnipeg chapter of Canadian Associates of Ben-Gurion University of the Negev, reported, there are over 22,000 Manitobans and over 600,000 Canadians who have been diagnosed with Alzheimer’s Disease, Lewy Bodies or another form of aged-related dementia.

The evening was co-hosted by the BGU Winnipeg chapter and Jewish Child and Family Service. “This is an inaugural partnership for our two organizations,” said Al Benarroch, the JCFS’ executive director. “(BGU Winnipeg executive director) Zach (Ostrove) came up with the idea for this program. He and I began talking about doing something together last fall. When it comes to dealing with the affects of aged-related brain disease, the JCFS is on the front lines.”

The bad news stemming from Toiber’s presentation is that thus far there is no imminent cure or foolproof preventative actions or medicines – although diet, exercise and keeping socially active may help delay onset of and slow the progression of the condition.The good news, she reported, is that her lab and other researchers around the world are making important strides in understanding the mechanisms explaining how aged-related brain disease develops.Originally from Mexico, Toiber made aliyah at 19. She earned a Ph.D. (2008) from the Hebrew University of Jerusalem and is currently doing post-doctoral work at Harvard in addition to his research at Ben-Gurion University with which she has been affiliated for four years.

She points out that one of the main causes of ageing is DNA damage and DNA damage accumulation. ”DNA damage,” she says, “can lead to four main outcomes. If the damage is slight, the cell will repair itself and life will go on.“If there is too much damage and the damaged cells could be dangerous to neighbour cells, the cells can decide to commit suicide in an altruistic manner.“Cells, (but not neurons) that are too badly damaged that don’t manage to die can become dangerous, as they transform into cancer cells.“In other cases, cells keep dividing and replenishing damaged tissue (to certain point) but our neurons are not dividing. If we start losing too many neurons, we lose brain function.”Toiber reports that her lab is working on understanding the molecular mechanisms of repair. “Today,” she says, “many labs are moving toward epigenetic (nongenetic) treatments that offer hope to the future.”

Where Toiber provided a clinical overview of aged-related brain disease, Norma Kirkby, program director for the Alzheimer’s Society of Manitoba, and community member Rose Popeski presented an overview of the stresses and challenges of caring for individuals with aged-related brain disease.Rose Popeski is the daughter of Holocaust survivors Oscar and Cesia Abramowitch. By the time, Oscar passed away a couple of months ago – at the age of 99 – the couple had been together for 72 years. In addition to a shared lifetime together, they also shared age-related dementia.“Because they were both Holocaust survivors and had been together for so long, I wanted to keep them in their home as long as possible,” she said. Her father, she reported, began showing signs of memory loss at about age 90 – at around the same time that her mother was hospitalized with a broken ankle. The WRHA wanted to move her father into a nursing home but Popeski successfully fought against that. While Manitoba’s Home Care program may be one of the best in Canada, it is still more of a stop gap than a solution for caregivers who want to keep their loved ones at home as long as they can. Popeski noted that initially, Home Care was prepared to send people out twice a day to help her father with meals. When her mother came home from hospital, she asked the WRHA for more help. The best that Home Care could do was a three-hour daily respite for her mother.“One of the problems with Home Care is that you are constantly getting new people in who have to be brought up to speed,” Popeski noted. “And there are times when the Home Care worker doesn’t show up at all. You end up having to hire people.”About a year after her mother came home from hospital, she also began showing symptoms of dementia. “My parents were each in worlds of their own,” she said. “We tried it all. Music therapy seemed to be somewhat effective. “The hardest part is seeing your parents like this. My mother doesn’t know anything anymore. “The hardest part of being a caregiver is the tremendous amount of stress you have to live with. It requires a great deal of patience and love.”

Following Toiber’s and Popeski’s presentations, the format took the form of a panel discussion, initially with Dr. Benedict C. Albensi, PhD, BCMAS, CRQM, Manitoba Dementia Research Chair Professor - Department of Pharmacology and Therapeutics, University of University, serving as moderator and asking the three panelists questions. Albensi first asked Kirkby what say dementia patients should have in decisions regarding their treatment. She replied that in the early stages, individuals can still have some input. In later stages, families should try to make decisions with the loved one’s long-time values in mind.In response to a question from Albensi about how to deal with the stress of being a caregiver, Kirkby pointed out that you have to train for the role with the idea in mind that this is a marathon, not a sprint.An audience member asked about potential benefits of marijuana in treating dementia. The response from the panelists is that there hasn’t been much research on the subject yet – only anecdotal reports.Toiber was asked what role genes play in aged-related brain disease. She noted that certain specific genes have been identified that play a role in early onset dementia – but that early onset accounts for less than 5% of individuals with brain-related disease. In response to a question about the use of stem cells in treating dementia, Dr. Albensi noted that while stem cell treatment may hold out promise of future treatment, there are still a lot of technical challenges.”Toiber fielded a question about the role of depression in triggering aged-related brain disease. She reported that studies seem to show that depression and other forms of mental illness may raise the odds of developing aged-related brain disease – but only by a very small amount. Also addressing the audience was Canadian Associates of Ben-Gurion University Executive Director Mark Mendelson, who praised the work of Zach Ostrove and the local chapter’s board members. Mendelson also spoke of the close working relationship between the St. Boniface Hospital and BGU researchers.Dr. Toiber’s stopover in Winnipeg was part of a cross Canada tour that began in Vancouver and was to conclude in Toronto.